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SA Disease Yr2 > Urinary System diseases > Flashcards

Urinary System diseases Flashcards

1
Q

Name the 5 main roles of the Urinary system

A
  1. Filter waste from blood + Excrete it as urine
  2. Maintain ECF balance
  3. Balance nutrients (e.g. minerals)
  4. Produce the hormone Erythropoietin (Stimulating bone marrow to produce RBCs)
  5. Assists w/regulation of pH + BP
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2
Q

What is Erythropoetin’s most vital role?

A

To stimulate the bone marrow to create/produce RBCs

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3
Q

What does UUTD stand for?

A

Upper Urinary Tract Disease

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4
Q

What 2 structures does UURT affect?

A
  1. Kidneys
  2. Ureters
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5
Q

What are the 2 types of UUTD?

A
  1. Chronic
  2. Acute
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6
Q

Give 2 basic Acute examples of UUTD

A
  1. Acute Kidney Disease (AKD)
  2. Acute Renal Failure (ARF)
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7
Q

Give 2 basic Chronic examples of UUTD

A
  1. Chronic Kidney Disease (CKD)
  2. Chronic Renal Failure (CRF)
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8
Q

What breed is the poster breed for Polycystic Kidney Disease (PKD) ?

A

Persians!

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9
Q

(10)

Name as many aeitologies for UUTD as you can!

A
  1. Infection
  2. Pyelonephritis
  3. Feline Infectious Peritonitis (FIP)
  4. Toxaemia
  5. Nephrotoxins
  6. Calculi
  7. Tumors
  8. Polycystic Kidney Disease (PKD)
  9. Secondary to Urinary Tract Obstruction (URTO) or other systemtic disease
  10. Acute on chronic Crisis!
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10
Q

What 2 things does Kidney disease eventually lead to?

A

Renal insufficiency > Renal failure

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11
Q

What does Renal insufficency mean?

A

Damaged kidneys that can still process waste, but clinical signs are not yet evident!

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12
Q

What is Renal failure?

A
  • Damage to the kidneys that increases to a point where waste cannot be processed
  • 75% of nephrons are damaged
  • Clinical signs are apparent
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13
Q

What is the difference between renal insufficiency + renal failure?

A
  • Renal insufficiency is when the kidneys can still function to filter minimal waste, despite the damage + no clinical signs are present
  • Whereas Renal failure is the where the irreversible damage has occured in 75% of the nephrons, where clinical signs are apparent
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14
Q

Does the kidney’s ability to concentrate urine decline earlier or later with kidney disease?

A

Early

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15
Q

What type of maintanance does the kidney perform that becomes affected when renal disfunction is decreased, due to disease?

A

Ability to maintain fluid + electrolyte homeostasis

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16
Q

Describe what occurs in Renal Functional Adaptation (RRA)

A
  • Renal Functional Adaptation is when the renal tissue begins to lose function and starts to compensate to adapt to the body’s needs
  • The remaining non-damaged tissue increases it’s performance (abnormally)
  1. The loss of 75% of nephrons/renal tissue causes a fall in the Glomeular Filtration Rate (GFR) to 50% of normal
  2. The plasma concentration of Creatinine + Urea rise as the GFR diminishes, leading to Azotaemia
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17
Q

What is the GFR?

A
  • The Glomerular Filatration Rate
  • A test used to estimate how much BP passes through the Glomeruli per minute
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18
Q

Define what is meant by Azotaemia?

A

An increase of Nitrogenous waste products in the blood stream

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19
Q

What nitrogenous waste products can be found in the blood, with Azotaemia?

A
  • Creatinine
  • Urea
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20
Q

What test can indicate the presence of Azotaemia?

A

BUN
(Blood, Urea, Nitrogen)

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21
Q

What 2 clinical signs may cause Azotaemia in the pre-renal disease stage?

A
  1. Dehydration
  2. Shock
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22
Q

What 2 clinical signs may cause Azotaemia in the Renal disease stage?

A
  1. Nephrotoxins
  2. Glomerulonephritis
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23
Q

What 2 clinical signs may cause Azotaemia in the post-renal disease stage?

A
  1. Urinary obstruction
  2. Trauma
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24
Q

What are the possible aietologies of Acute Kidney Disease/Failure?

A
  • Toxins
  • Trauma
  • Lower Urinary Obstruction
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25
Q

What happens to the cells + renal blood flow with Acute Kidney Disease/Failure?

A
  • Cellular damage
  • Reduced renal blood flow occurs
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26
Q

True or False.

Acute Kidney Disease/Failure does not require emergency treatment + hospilisation.

A

False!
It’s a vital emergency!

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27
Q

True or False.

AKD or AKF can present with the same clinical signs as Azotaemia.

A

True!
As Azotaemia is clinical sign that is evident with AKD or AKF.

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28
Q

True or False.

Once the kidneys are no longer able to compensate, the patient will present with signs of KF.

A

True

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29
Q

What is the most common aetiology for CKD?

A

Idiopathic deterioration of the geriatric cat!

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30
Q

(8)

Name as many aietologies for CKD as you can

A
  1. Idiopathic deterioration
  2. Previous acute renal damage (Due to injuries or toxins)
  3. Neoplasia
  4. PKD
  5. Chronic infection
  6. Pyelonephritis
  7. Glomerulonephritis
  8. Concurrent conditions (DM, Hypertension)
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31
Q

What is the basic pathophysiology of Renal Failure?

A

The kidney is simply unable to filter the nitrogenous waste from the blood

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32
Q

What is Uraemia + Why do RKF patients present with this?

A
  1. Uraemia is the presence of high levels of Urea in the blood
  2. Urea is a nitrogenous waste product excreted by the kidneys, normally in the urine. When the kidneys lose their ability to filter these waste products, they build up in the blood, leading to Uraemia
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33
Q

Finish the sentence.

Deterioration of renal function causes p_ + e_________ ________ in RF.

A

pH + Electrolyte imbalances!

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34
Q

What 2 minerals become imbalanced due to a decrease in renal function?

A
  1. Potassium
  2. Phosphate
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35
Q

What hormone, excreted by the kidney, leads to reduced erthyrocute formation in the bone marrow?

A

Erythropoietin!

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36
Q

What does ‘reserve capacity of the kidney’ mean?

A

That the clinical signs of RF only appear when 2/3 - 3/4 of the functioning tissue is lost

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37
Q

What urinary disease presents with the following Clinical signs? …

  • Oral ulcers
  • Hallitosis
  • Depression
  • V+
  • Inappetance
  • Weight loss
  • Anorexia
  • Seizures
  • Anuric (End stage)
  • PD/PU
  • Dehydration
  • Anaemia (If chronic)
A

CRF!

38
Q

How is CKD/F diagnosed?

A
  1. History
  2. Clinical signs
  3. Physical exam
  4. Urinalysis
  5. Specific Gravity
  6. Blood tests
  7. Blood Pressure
  8. Radiography
  9. Ultrasound

NOTE: Important to determine the cause + extent of Azotaemia!

39
Q

What are the3 most prominent diagnostic tools for diagnosing CKD/F?

A
  1. Urinalysis
  2. SG
  3. Bloods
40
Q

What blood tests should be performed when diagnosing CKD/F?

A
  • BUN
  • Look for elevated levels or Urea + Creatinine in the plasma!
41
Q

When looking are Urea + Creatinine levels in the plasma, for diagnosing CKD/F, what may rise first?

A

Creatinine

42
Q

What diagnostic tests should be performed that is more sensitive to early changes of CKD/, alongside the Creatinine IRIS staging?

A

SDMA testing!
(Symmetric Dimethylarginine)

43
Q

What is SDMA testing + why is it important for diagnosing CKD/F?

A
  • SDMA (Symmetric Dimethylarginin) is an AA produced by the body when protein is broken down + excreted in the kidneys.
  • Sensitive biomarker of kidney function + can detect kidney issues as early as 25% loss of kidney function
44
Q

Why should you check electrolyte levels when diagnosing CKD/F?

A

Because phosphate levels increase with CKD + may be used to detect Hypokalaemia

45
Q

What USG figure is representative of CKD/F in Cats?

A

< 1.035

46
Q

What does USG identify in CKD/F?

A

To identify the loss of concentrating ability of the kidneys

47
Q

True or False.

Increasing USG raises suspicion + often another early sign of CKD/F.

A

False, declining USG would! As the kidney’s ability to concentrate is imparied.

48
Q

True or False.

Urine Protein levels will increase if kidney function is imparied.

A

True

49
Q

What 2 things should be ruled out when diagnosing CKD/F?

A
  • Presence of blood in urine
  • Signs of infection
50
Q

What establishment is known to develop staging for CKD/F?

A

IRIS

51
Q

(9)

How is CKD/F treated?

Name as many treatments as you can.

A
  1. IVFT
  2. Diet management - phosphate restriction
  3. Drugs (ie. Antibiotics)
  4. Phosphate binders
  5. Potassium supplementation
  6. Managing hypertension (Amlodipine)
  7. Treat anaemia (Nandralone, Erythropoietin)
  8. Monitor urine infections
  9. Manage anorexia + V+
52
Q

Ethical dilemma - should we offer Kidney transplants in Cats?

A

No.

This is because CKF or AKF occurs when there is a loss of 75% of renal tissue, if 50% is taken and given to another, the donor is almost garaunteed to end up in the same situation as the recipient!

53
Q

What does LUTD stand for?

A

Lower Urinary Tract Disease

54
Q

What 2 main structures does LUTD affect?

A
  1. Bladder
  2. Urethra
55
Q

(8)

Name as many possible aetiologies as you can for LUTD.

A
  1. Infection
  2. Calculi/Crystals
  3. Neoplasia
  4. Trauma
  5. Iatrogenic
  6. Neurogenic
  7. Concurrent diseases (i.e, DM)
  8. Idiopathic
56
Q

What is the most common aetiology of LUTD?

A

Idiopathic!

57
Q

(16)

Name as many clinical signs of LUTD as you can.

A
  1. Cystitis
  2. Pollakuria
  3. Dysuria
  4. Haematuria
  5. Pain
  6. Blockage
  7. Oliguria
  8. Anuria
  9. Incontinence
  10. Varying frequency/volume of urine
  11. Abnormal micturition (weak or interrupted)
  12. Licking external genitalia
  13. Depression
  14. V+
  15. Anorexia
  16. Dehydration
58
Q

What possible urinary disease may present with these clinical signs?
* Blockage
* Licking external genitalia
* Abnormal micturition
* Cystitis
* Oliguria
* Anuria
* Depression
* V+
* Incontinence
* Haematuria

A

LUTD

59
Q

What LUTD is common in Cats?

A

Feline Lower Urinary Tract Disease
(FLUTD)

60
Q

What LUTD has a multifactorial in Cats?

A

FLUTD

61
Q

What is the most common aetiology of FLUTD?

A

Idiopathic Cystitis!

62
Q

(8)

Names as many aetiologies for FLUTD as you can.

A
  1. Idiopathic Cystitis
  2. Urolithiasis
  3. Crystals (Urethral plug)
  4. Infection - rare
  5. Stress of living in a Multi-cat household
  6. Underactive lifestyle
  7. Overweight
  8. Neutuering
63
Q

Why may bladder palpation be painful in a cat with FLUTD?

A

Because the urethra may be/is blocked!

64
Q

What does FIC stand for?

A

Feline Idiopathic Cystitis

65
Q

What is FIC + how can it cause FLUTD?

A
  1. FIC = Feline Idiopathic Cystitis
  2. Because there is irritation or inflammation of the bladder wall/urethra
66
Q

What can cause recurrent bouts of Cystitis?

A

FIC + FLUTD

67
Q

What 2 things can cause a urinary obstruction, leading to FLUTD?

A
  1. Uroliths
  2. Urethral plugs
68
Q

True or False.

Urotliths or Urethral plugs in the FLUT is not deemed an emergency.

A

False - it is!
Always be wary of a blocked cat, especially males!

As this will lead to Azotaemia + clinical signs of ARF!

ARF = Acute Renal Failure

69
Q

1 is very dangerous!!

What can trauma or Iatrogenic damage result in with FLUTD?

A

Bladder wall dysfunction or rupture of the urinary tract!

70
Q

What does ARF mean?

A

Acute Renal Failure

71
Q

What 2 dangerous things does inability to void urine lead to?

A
  1. Azotaemia
  2. ARF
72
Q

Name 4 urinary crystals that can be found in FLUTD

A
  1. Struvite
  2. Calcium oxalate
  3. Cystine
  4. Ammonium urate
73
Q

Name this urinary crystal

A

Struvite

74
Q

Name this urinary crystal

A

Calcium oxalate

75
Q

Name this urinary crystal

A

Cystine

76
Q

Name this urinary crystal

A

Ammonium urate

77
Q

Name the 3 most important diagnostic tools used to diagnose FLUTD

A
  1. Urinalysis
  2. Radiography
  3. Ultrasound
78
Q

(9)

Name as many diagnostic tools used to diagnose FLUTD as you can

A
  1. History
  2. Clinical signs
  3. Physical exam
  4. Observation of micturition
  5. Neurological examination - where indicated
  6. Urinalysis - visual appearence, dipstick, microscopy, culture + USG
  7. Ultrasound
  8. Haematology
  9. Biochemistry
79
Q

(13)

Name as many treatment options for FLUTD as you can.

A
  1. Treat cause
  2. Clear blockages
  3. Empty bladder
  4. Catherisation
  5. Sterile saline
  6. Cystocentesis
  7. Increase water intake
  8. Resolve any toileting problems (i.e. Litter trays)
  9. Antibiotics
  10. NSAIDS
  11. Analgesia - if indicated for pain
  12. Diet management + modification
  13. Pheromone treatment
80
Q

What occurs in PKD?

A

Normal kidney tissue is gradually replaced by multiple fluid filled cysts

81
Q

What infections occur with CKD?

A

Bacterial infections - otherwise known as Pyelonephritis

82
Q

Name an example of a kidney tumour that may cause CKD

A

Lymphoma

83
Q

What is Lymphoma?

A

A solid tumour of the WBCs

84
Q

What is meant by Glomerulonephritis?

A

Inflammation of the glomeruli (the individual units within the kidney that filter the blood) + may become inflamed for various reasons - if prolonged - lead to CKD

85
Q

True or False.

Hypercalcaemia may cause CKD, but studies are still ongoing..

A

True

86
Q

What age do Cats commonly present with CKD?

A

Middle - old age
or
Over 7 y/o

87
Q

What percentage of Cats are estimated to have CKD over 15 y/o?

A

15-20%

88
Q

True or False.

CKD is 5x more common in Cats than Dogs.

A

False.

It’s 3x more likely!

89
Q

True or False.

ACE inhibitors cannot be used with Cats with CKD.

A

False.

Blocking the activation of the hormone, Angiotensin, with ACE inhibitors such as Benazepril or Enalapril or ARBs (Angiotensin Receptor Blockers), such as Telmisartan act as vasodilators to:
* Increase blood flow through the kidneys
* Help lower BP
* Reduce protein loss

90
Q

What 2 sections are FLUTD subdivided into?

A
  1. Obstructive
  2. Non-obstructive
91
Q
A

SA Disease Yr2 (23 decks)

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